"He would grab a stool and bounce off the wall, quite literally," Stephens said, shaking his head in amazement. "He'd race up and down the hall here. He just couldn't sit still. Although he's only 5, his mother already is almost unable to deal with his behavior."

Stephens recognized an "attention deficit disorder," a learning disability that typically turns children into school failures--unless they get potent remediation early. Children like this 5-year-old eventually make up about half of the teen-age delinquency roll, Stephens said, and later they often acquire long felony records.

Stephens put the boy's family in touch with an Encino foundation that is now working with the youngster. He will be evaluated at 6, and the foundation staff will do all the remediating work needed for free, a step that Stephens hopes will make a positive impact on the rest of the child's life.

An Average Month

He was one of 175 young patients treated during an average month at the Skid Row Children's Clinic, open Tuesday afternoons and evenings in the Hollywood Sunset facility on Sunset Boulevard in the Echo Park area.

About three out of four youngsters brought in have never seen a doctor before, medical director Dr. William Vicary said. They lack basic pediatric care, such as polio and diphtheria shots. Currently staffed by volunteers and a small paid staff, the clinic serves parents who are referred by schools, child-care centers or, most often, by word of mouth.

A recent study by Pacific Bell Telephone Co. found that Hollywood Sunset was getting 2,000 phone calls per week, the majority about children, according to clinic executive director Teresa Padua.

Lone Safety Net

Needs appear to be mounting as medical costs soar, as more immigrants flood into the Los Angeles area and as unemployment leaves more families with no health benefits. For many, the free clinic is the only safety net under them.

"We have to turn away as many as we see each week," said Stephens, a family practitioner.

It's a last resort for some. Padua spoke of a 6-year-old boy with a broken arm that was healing crookedly, which could have left him handicapped for life. "We got a call about it from one of the local day-care centers. They asked if we'd see him," she said. In desperation, the child's parents earlier had used somebody else's Medi-Cal card at a clinic. Now they were afraid to go back. "His arm needed to be reset and although we don't do that here, one of our volunteer doctors took him to his clinic and did it for free, so it would heal properly," Padua said.

Some incidents reflect the unique challenges of life as an immigrant, often an illegal one, who has witnessed violent episodes before experiencing culture shock in a new country.

Nurse practitioner Lisa Guravitz talked about the 9-year-old boy who recently came in with a severe fungus on his toes, a type of ailment that takes six months of treatment. "He walked here from El Salvador," she said.

"This kid is petrified. When you talk to him, you find out he lives in a constant state of fear," Guravitz said. "He knows they're here illegally. Will they get caught? Will they be forced to go back?"

Stress-linked health problems abound. "These are kids who sometimes have seen their parents dragged off and murdered," she said. It's not surprising that they develop headaches and stomach pains or bed-wetting at 10, she observed.

Diseases of Poverty

The medical staff routinely treats typical diseases of poverty--parasites, anemia and vitamin deficiencies. "Because there's such a high infant mortality rate where they come from, many of them (mistakenly) want their children to be fat," Guravitz explained. She does basic nutrition education with parents, teaching them about the nutrient-rich foods needed for thriving children. Vitamin or iron supplements are prescribed from the clinic's dispensary to bring kids up to par in energy and nutritional status.

When parents bring in their youngsters, they often then use the preventive services available for adults, Padua said. The staff does breast exams and cancer-screening Pap smears, along with family-planning education.

The rambling, 15-room clinic also includes a lab for simple medical tests, such as for TB and anemia, an emergency room for minor mishaps and a dental room. Glendale dentist Dr. Geoffrey Shanklin donated much of the equipment, then found colleagues who would contribute the rest. The only dentist currently volunteering at the clinic, Shanklin works every other Wednesday afternoon. He's looking around for other dentist volunteers and more needed equipment.